More and more Canadians are opting for a controversial treatment for losing weight
BY ALEXANDRA SHIMO • It took about 120 tiny pinpricks to create Nicole Mutch’s toned, washboard stomach. That and $2,000 and eight sessions at a plastic surgeon’s office. The fat-reducing injections were so successful, she went back and had her rear done too. Mutch, 37, is one of a growing number of Canadians—and most are women—opting for this cutting-edge treatment. The procedure is as revolutionary as it is simple: the flabby area in question is injected with a chemical—either phosphatidylcholine deoxycholate (PCDC) or deoxycholate (DC)—directly into the layer of fat and connective tissue under the skin. And voila, the patient returns home, or back to work, and the shrinkage begins (the excess is excreted by the kidneys). “There was no pain afterwards,” Mutch explains from her home in Mississauga, Ont. “I wanted to tighten my stomach to get rid of the red and white stretch marks, which I got from having kids. I lost 2.5 inches [6.35 cm] from my stomach, and the same from my rear.” The average reduction, says Dr. Stephen Mulholland, the Toronto plastic surgeon who treated Mutch, is 8.5 cm in the stomach and 6.3 cm for the thighs.
Mesotherapy was developed in Europe and became popular in South America in the late 1990s. It took off in Brazil, where soon it wasn’t just doctors injecting patients, but beauty technicians and massage therapists. Concern over the uncontrolled use, and lack of research on long-term side effects, caused the Brazilian government to ban its use in 2003.
In Canada, the growth of the procedure has also been rapid. Fat-reducing injections are done in every major city in Canada, says Mulholland, who also trains other doctors in the technique—on average, 30 to 40 doctors take his courses every month. In the U.S., the main company offering the procedure, Advanced Lipo Dissolve Center, has treated more than 50,000 patients since opening its doors in September 2005. “There is a 96 per cent success rate at melting fat,” says Mulholland from his Toronto clinic, SpaMedica. “All the studies show this procedure is entirely safe.”
But most of the studies, says Dr. Alan Matarasso, a clinical professor of plastic surgery at the Albert Einstein College of Medicine and president of the New York Regional Society of Plastic Surgery, examine a handful of patients over a period of a few weeks or months. Matarasso, who published an article examining all the scientific research on the subject in the journal of the American Society of Plastic Surgeons in April 2005, adds that there haven’t yet been any studies looking at the long-term effects of mesotherapy. (The known side effects, says Mulholland, include burning, redness and local swelling. For a few patients, the fat does not dissolve, but forms a palpable lump under the skin. Some patients who have been injected with PCDC, Mulholland adds, have reported nausea, vomiting and seizures.)
Neither of the two substances have been recognized by Health Canada for use in fatreducing injections. Since it does not regulate off-label use of drugs, there are no official guidelines on dosage or possible side effects. DC is an approved substance—in AmphotericinB, a treatment for fungal infections, and in doses 1,000 times less potent. In the U.S., the Food and Drug Administration has taken a harder line, sending out warning letters to companies using the off-label drugs, ordering them to stop injecting patients immediately.
For these reasons, some doctors are highly critical of the procedure. “There is almost no scientific data to support almost any of the claims that are made for mesotherapy,” says Dr. Rod Rohrich, past president of the American Society of Plastic Surgeons and chairman of the department of plastic surgery at the University of Texas. “It’s bordering on human experimentation.” Matarasso agrees. “For some reason we suspend all reality when we talk about fat. If I gave you a pill for pneumonia and I told you I didn’t know the correct dose, side effects, longterm results, you’d be incredulous.”
Mutch says she hasn’t really given much thought to long-term effects. “In these matters you are your own worst critic, and it really helped. I’m still seeing the results.” Mutch’s attitude is precisely the reason the therapy has taken off, Matarasso says. “Human nature wants something easy for fat. And people would prefer a non-surgical to a surgical solution. So when you put all those things together it’s a perfect marriage. The problem is there are very few scientific studies on this. There are a lot of unknowns.” M
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